Meeting documents

At the Committee’s July meeting, Members undertook an Inquiry looking at how well the council is prepared for the planned future growth.  This was a piece of work across all the Select Committees.  The purpose of this item is for the Committee to evaluate how well public health is embedded across the County and review the strength of key stakeholder relationships.

Attendees:

Mr N Brown, Cabinet Member for Community Engagement & Public Health

Dr J O’Grady, Director of Public Health

Papers:

Presentation attached

Intended outcome:

For Members to be reassured that Public Health services are embedded across the Council and that Public Health is at the heart of all discussions, particularly around future growth plans for the County.

The Chairman welcomed Mr N Brown, Cabinet Member for Community Engagement and Public Health and Dr J O’Grady, Director of Public Health. 

Mr Brown declared an interest as his daughter was a nurse at Frimley Park Hospital and confirmed the nurses were working extra shifts to cope with the winter pressures. 

Mr Brown reported that the Public Health team was leading the work stream on the social care transformation plan.  Mr Brown stressed the importance of engaging with older people before their situation became a crisis.  The Public Health team were very involved in prevention and the prevention at scale pilot to try to keep people healthy for longer. 

Dr O’Grady provided a brief overview of the presentation in the agenda pack and made the following points: 

• A core value for Public Health was to improve the wellbeing of the population and narrow the gap in healthy life expectancy between different residents in the community.

• 25% of health was due to health care received, the rest was due to wider determinants of health.

• What happens before you were born affected your life as a child and an adult.  It affected education prospects, health and chances of success. Public Health worked across the life course and looked for opportunities everywhere to improve people’s health and wellbeing.

The following comments were made in response to questions from the Committee.

• In response to a query on how people were helped to maintain their wellbeing and resilience, Dr O’Grady replied that the main drivers for health were the environment, personal resilience, good mental wellbeing and physical health.  The critical group was the 40-65 year olds.  If someone was healthy in mid-life there was an increased chance of ageing without frailty and dementia.  Dr O’Grady advised that NHS Health checks were available for everyone eligible in that age range (a person was eligible if they did not already have a condition such as high blood pressure or diabetes as they would already be being looked after).  The rate of take up for the NHS Health checks was approximately 45-48% which was similar to other counties.  The GP surgeries called people in on a five year rolling basis and Health checks were also available in outreach services.  There was also the lifestyle service which provided a range of services such as  smoking cessation and weight management.

• Public Health was one of 15 local authorities taking part in a national pilot called "Prevention at Scale".  The aim was to get the message out to people in the community.

• Dr O’Grady agreed it was important to maintain the activity groups and make them sustainable as they were often in areas where they were most needed.

• Teaching school children about healthy eating and ensuring healthy options were available at food outlets would help prevent childhood obesity.   Mr Brown added that the High Wycombe foodbank wanted to include fresh food but realised they would have to teach cooking and that was now in place. 

• Public Health England was responsible for working with the government to lobby food manufacturers to produce healthier food.

• Some local authorities had managed to limit the density and proximity of fast food outlets but it tended to be a voluntary code.

• Dr O’Grady was asked to explain about the work Public Health was undertaking with the district councils and other health partners. 

o    There was a Healthy Communities Partnership (HCP) which consisted of members from each of the district councils, the NHS and Public Health.  The HCP sat under the Health and Wellbeing Board (HWB) which had a wide representation of organisations. 

o    A lot of work had taken place with the District Councils on the physical activity strategy. 

o    A themed workshop on health and wellbeing had taken place with Public Health, the Clinical Commissioning Groups, District Councils and Youth Services. 

o    The District Councils were also on the steering group of the community organising project in High Wycombe. 

o    The next Director of Public Health Annual Report would be on how we build health and wellbeing into the built and natural environments.

o    Dr O’Grady offered to take representatives from HASC to visit the Bicester healthy new town along with the district council representatives on the HWB.  The Chairman said it was essential that HASC was represented.

Action:  Dr O’Grady

• The key challenges facing Public Health were:

o    To help communities to be healthy.

o    There would be less money available for an ageing population who was not ageing healthily. 

o    Mental health and wellbeing in a very changing world; national campaigns would be needed.

• In response to a question about how to measure the success in changing lifestyle, Dr O’Grady made the following points:

o    A risk factor in low birth weight babies was smoking in pregnancy which could be easily monitored.  A prematurity clinic had been set up to prevent early births and children were measured in early years to check their development.

o    There were national surveys on physical activity with 2,000 people in Buckinghamshire included in the sample.

o    Admissions to hospital relating to self-harm and alcohol related conditions were being studied.

o    Smoking cessation was a non-mandatory service but was cheap to run and there had been very good quit rates.

o    The weight management service was another non-mandatory service but was very effective.

o    The lifestyle services had been halved in order to protect mandatory services such as substance misuse and sexual health services.

o    80% of the Public Health budget was spent on mandatory services and 20% on other non-mandatory services such as domestic violence and children’s services.

• Marketing had to be smart. 

The Chairman thanked Mr Brown and Dr O’Grady for attending.